American Diabetes Association Complete Guide to Diabetes. American Diabetes Association

open. Some meters take a testing “disc” (containing enough room for multiple blood samples) or a drum with preloaded strips.

      You’ll want to research the price of test strips as you consider which blood glucose meter to purchase (see more on this topic below). Test strips usually come in boxes of 50 or 100, and you can buy them online or in stores. The box of test strips will have an expiration date, and individually packaged strips usually last about 2 years. In the past, the U.S. Food and Drug Administration uncovered schemes to distribute counterfeit test strips. Always buy your strips from a reputable retailer, and check the FDA website (www.fda.gov) for updates on test strips or call the manufacturer if you have any concerns.

      Sometimes, in rare cases, people who take certain medications containing sugars that aren’t glucose or who are undergoing medical procedures may receive false high readings with certain strips. Be sure to discuss your strips with your health care provider if you are put on a new medication or if there is a change in your health status.

      Generic Test Strips

      You can also buy generic brands of test strips that are manufactured to work with specific meters. Make sure that the generic brand lists your meter on the packaging or in the product information.

      Test Strip Storage

      Test strips should be stored in their covered container and kept in a dry area. Not keeping your strips safe and dry could affect their accuracy. For example, keeping strips in the bathroom with the container uncovered may result in false blood glucose readings.

Blood Glucose Meters

      If your doctor has told you that you need to frequently self-check your blood glucose, then a blood glucose meter is an essential tool for taking care of your diabetes. Only by keeping close tabs on your blood glucose levels and recognizing when they are out of range can you take steps to remedy the situation.

      The meter measures an electric current in the blood that depends on the amount of glucose present. A sample of blood is placed on a small area of a test strip or disk. A special enzyme transfers electrons from glucose to a chemical in the strip, and the meter measures this flow of electrons as current. The amount of current depends on how much glucose is in the blood. This weak current flows through the strip and is measured in the meter. The meter produces an electronic reading of blood glucose levels in milligrams per deciliter (mg/dl).

      There are also several meters that check more than blood glucose. One meter measures blood glucose and ketones (a byproduct that can indicate a serious medication problem). Another meter measures blood glucose, ketones, and lipids (including HDL and LDL cholesterol and triglycerides).

      Plasma Versus Whole Blood

      Meters measure the amount of glucose in whole blood, which is the complete composition of the blood flowing through the body. More simply, whole blood is the blood that is directly drawn from the body without further treatment. Several blood-glucose testing methods, however, measure the glucose contained in blood plasma. Plasma is a yellow liquid component of whole blood that has to be separated from blood using laboratory methods. The issue is that tests yield different blood glucose results when performed on whole blood versus blood plasma. Plasma test results tend to be 10–15% higher than results from whole blood.

      Even though they measure the glucose levels in whole blood, today’s meters are adjusted to provide results in the plasma glucose equivalent, so blood glucose test results are consistent among all testing measures.

      The sheer number of blood glucose meters on the market can be overwhelming. But the good news is that consumers now have more choices than ever in finding a device that fits their budget and lifestyle. Considerations for a blood glucose meter break down into roughly three categories: cost, performance, and your lifestyle. The following section will explore each category in detail.

      Considerations for Buying a Blood Glucose Meter

      • Cost: Insurance coverage, price of test strips

      • Performance: Accuracy, batteries, and meter replacement

      • Lifestyle: Meter size, your vision and language, test site, user-friendliness, meter memory, and data management system

      Cost Considerations

      The cost of your blood glucose meter should be a consideration as you research different brands. Your health insurance may cover the cost of a meter and maybe the test strips. Meters are usually deeply discounted by the manufacturer through rebates and coupons, but you’ll want to analyze the long-term costs of any meter and the strips before you purchase it.

      Insurance Coverage

      Check with your insurance plan or company health program before you invest in a meter. For example, Medicare covers the cost of meters, strips, and lancets. Your insurance may pay for only specific meters or have a cost allowance. Also find out if you are covered for the test strips and how many you are allowed per year. Your insurance may cover more of the cost of meters and strips through a mail-order program. However, you will need to get a prescription to be reimbursed.

      Price of Test Strips

      In the long run, your meter’s test strips will cost you much more than the meter itself. You may be surprised by the cost when you go to buy replacement strips for your meter. The meter that seemed like a bargain at the time of purchase may turn into a major expense when it comes time to pay for strips (especially if you don’t get reimbursed for them by your insurance). Make sure you check the cost of the strips your meter uses before you buy it. Check Diabetes Forecast’s Consumer Guide and ads for lists of companies that sell discounted strips.

      Performance Considerations

      The U.S. Food and Drug Administration (FDA) regulates all meters made and distributed in the United States. Manufacturers are required to list devices with the FDA, as well as follow guidelines for marketing, labeling, safety, and efficacy. However, you—as the primary user—will be responsible for checking the performance of your meter over time.

      Accuracy

      Some machines require that you code each new batch of test strips with your meter in order to maintain accuracy (some do not). Test strips can vary from batch to batch. There may be differences in the amount of chemical on the strips in each batch. So you must standardize (or code) your meter to make up for these small differences when you open a new batch of strips. If you don’t code, all your results with the new strips may read higher or lower than they really are. Instructions for coding are included in every new package of strips. Some meters automatically code themselves—you don’t have to do anything when you open a new batch of strips or the disk.

      You’ll also want to check the accuracy of your meter from time to time. You can do this one of three ways: perform an electronic check, use a “control” solution or strip, or compare your meter with a laboratory meter.

      Your meter should perform an electronic check every time you turn it on. It will give you an error code if something is wrong. You can check the owner’s manual for instructions for correcting errors.

      Meters often provide a standard solution, known as a “control” solution. This solution contains a known amount of glucose to help check for accuracy. Other meters use a control strip to check for accuracy. If you measure the amount of glucose in this standard solution or strip in your meter and your meter shows a reading that is too high or too low, your machine may be giving you a faulty reading. The manufacturer’s instructions will tell you how often to check with the control solution or strip for the best accuracy.

      Write the date on your control solution when you open it and remember that it is usually good for one to three months, depending on the manufacturer.

      If you are having a problem with accuracy, first check to see if your